2009, Number 5
Rev Mex Urol 2009; 69 (5)
Surgical pathology of the adrenal gland: cases managed at the Dr. Manuel Gea González General Hospital over a period of 20 years
Cantellano-Orozco M, Merayo-Chalico C, Shuck-Bello C, Saavedra-Briones D, Camarena-Reynoso H, Vázquez-Ortega L, Leos-Acosta C, Morales-Montor G, Pacheco-Gahbler C, Calderón-Ferro F
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ABSTRACTObjective: To present 20 years of experience in the surgical management of adrenal pathology at the Urology Service of the Dr. Manuel Gea González General Hospital.
Materials and methods: Case records of patients treated for suprarenal lesions at the urology service from 1988 to 2008 were reviewed. There were a total of nine cases: 1 simple adrenal cyst, 2 myelolipomas, 4 pheochromocytomas, 1 primary adrenal leiomyosarcoma and 1 adrenal adenoma.
Results: The nine cases included 4 men (35-63 year age range) and 5 women (30-65 year age range). There were 7 lesions in the right gland and 2 in the left. Five were functional tumors and 4 were non-functional. Four of the functional tumor cases were chromaffin tumors (pheochromocytomas) and 1 case was adrenal cortex tumor. Of the non-functional tumors 2 cases were incidentalomas (myelolipomas), 1 case was adrenal cyst and one was primary adrenal leiomyosarcoma. Of the nine cases open surgery was performed in 7 of them, one with the thoracoabdominal approach, and laparoscopic surgery was performed in 2 cases. Follow-up time ranged from 3 months to 12 years. No intra- or postoperative mortality was reported.
Discussion and conclusions: Adrenal pathology incidence is low in the hospital population as can be seen by the fact that there were only 9 cases over a period of 20 years in a public institution providing general consultation. Chromaffin tumor pathology was the most frequent tumor type and histology was varied in the others. Multidisciplinary approach offered adequate management and prognosis.